Provider Demographics
NPI:1053948547
Name:COMFORT AT HOME PERSONAL CARE ASSISTANCE CORP
Entity type:Organization
Organization Name:COMFORT AT HOME PERSONAL CARE ASSISTANCE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-321-6994
Mailing Address - Street 1:1820 E SAHARA AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3736
Mailing Address - Country:US
Mailing Address - Phone:702-262-1202
Mailing Address - Fax:702-749-6232
Practice Address - Street 1:1820 E SAHARA AVE STE 114
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3736
Practice Address - Country:US
Practice Address - Phone:702-262-1202
Practice Address - Fax:702-749-6232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9950Medicaid
NV9950OtherPERSONAL CARE SERVICES